Hospital Quality Rating System Delayed by CMS

Is that hospital where you just had open-heart surgery a five star or a one star? You’ll have to wait until July, at the earliest, to find out. The Centers for Medicare and Medicaid Services (CMS) yesterday delayed implementation of its hospital quality rating system that was set to debut this week amid questions about […]

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Obamacare Sign-Ups Fall Short of Goal for 2016

On Dec. 31, 2015, about 8.8 million consumers had effectuated Health Insurance Marketplace coverage -– which means those individuals had paid their premiums and had an active policy at the end of December, the Centers for Medicare and Medicaid Services (CMS) announced. The original goal was 9.1 million paying customers. Of the approximately 8.8 million […]

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CMS Seeks to Cut Medicare Drug Payments

The Centers for Medicare & Medicaid Services (CMS) has announced a proposed rule to test new models to improve how Medicare Part B pays for prescription drugs and supports physicians and other clinicians in delivering higher quality care. CMS values public input and comments as part of the rulemaking process, and looks forward to continuing […]

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Risk Corridor Program Expects to Redistribute $7.7 Billion

The risk corridor/reinsurance program of the Affordable Care Act (ACA) is expecting collections of $7.7 billion under the program this year to compensate insurance companies that suffered losses because of high claims in 2015. The Department of Health and Human Services (HHS) will commence payments in March and wrap them up by June 30 when HHS releases […]

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CMS Announces Special Enrollment Period Confirmation Process

After big insurers like UnitedHealthcare threatened to leave the Obamacare exchanges because of abuse of the system, the Centers for Medicare and Medicaid Services (CMS) announced this past week that it was creating a Special Enrollment Period (SEP) Confirmation Process, to be phased in after public feedback. The CMS site says: Once the new Special […]

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UnitedHealth, Humana Bleed Red for Obamacare

UnitedHealth Group Inc., the nation’s largest health insurer which last year said it might withdraw from the Obamacare insurance exchanges, this week increased projected 2016 Affordable Care Act (ACA) losses from $400 million to $500 million. Humana Inc. also disclosed that it was setting up a “premium deficiency reserve” for its anticipated 2016 ACA losses. […]

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Consumer-Friendly Features Added to HealthCare.Gov

As consumers count down to today’s enrollment deadline for Jan. 1 coverage, the Centers for Medicare & Medicaid Services (CMS) announced that new HealthCare.gov consumer decision support features piloted earlier this enrollment season are now fully deployed for all visitors.  The new Out-of-Pocket Cost calculator, Doctor and Facility Lookup, and Prescription Drug Lookup features will help consumers to […]

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Obamacare Sign-Ups Already Surpass Dec. 15 Goal

Though critics claim the goal of 900,000 new Obamacare sign-ups by Dec. 15 was modest to begin with, the Centers for Medicare and Medicaid Services (CMS) announced this week that the state and federal exchanges have already secured 1 million new enrollees. In all, 2.83 million have signed up this year, according to CMS. Dec. 15 […]

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Obamacare Risk Corridors Program to the Rescue?

As part of the Affordable Care Act (ACA), Congress included a provision called the “risk corridors program” that collects money from insurance companies making money and then distributes it to companies losing money. The program is set to run through 2016, but with a severe limitation. Congress in 2014 passed, and the president signed, a […]

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HealthCare.gov Beta Tests Doctor Lookup Feature

Beginning today, HealthCare.gov is piloting a new beta feature that allows consumers to search plans by their preferred provider or health facility. Some consumers will be part of a pilot that allows them to use the beta Doctor Lookup feature as they compare their coverage options in window shopping or when selecting a plan. “The […]

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